The teachings of all of the references cited herein are incorporated herein by reference.
Calcitonin is a polypeptide hormone secreted by the parafollicular cells of the thyroid gland in mammals and by the ultimobrancial gland of birds and fish. Synthetic salmon calcitonin is produced and sold by Novartis Pharmaceuticals Corporation (East Hanover, N.J.). It is used to treat a variety of conditions including postmenopausal osteoporosis, symptomatic Paget's disease of bone, and hypercalcemia. Calcitonins have been extracted from a number of sources including salmon, porcine, eel and human. Calcitonins with amino acid sequences identical to the natural forms have been produced by chemical synthesis as well as by recombinant technology.
Currently calcitonin is administered either by subcutaneous or intramuscular injections or it is administered intranasally. Intranasal administration of calcitonin is disclosed in U.S. Pat. No. 5,759,565. The nasal formulation was designed to be stored in a multi-dose container that was stable for an extended period of time and resisted microbial contamination. The preservative in the formulation, benzalkonium chloride has been shown to aggravate rhinitis in healthy volunteers who were given a decongestant nasal spray containing the preservative, and allergic reactions to the intranasal salmon calcitonin spray MIACALCIN® have been reported, including one of anaphylactic shock. This is believed to be due to the preservative benzalkonium chloride because the patient could tolerate injectable salmon calcitonin, which contains no benzalkonium chloride, without incident. See the ‘Physicians Desk Reference’ 2002 edition page 2375 (Medical Economics, Montvale, N.Y.). Benzalkonium chloride also has adverse (Hallen, H et. al., Clin. Exp. Allergy 25: 401-405 (1995). Also studies have shown that when respiratory mucosal tissue is exposed to benzalkonium chloride in vitro, the tissue underwent severe morphological alterations, Berg et al., Larynogoscope, 104:153-1158 (1994). Benzalkonium chloride also caused significant slowing of the mucocilary transport velocity in the ex vivo frog palate test, Braga, P. C., et al., J. Pharm. Pharmacol. 44:938-940 (1992).
Thus, there is a need for a new formulation of intranasal calcitonin that contains a preservative other than benzalkonium chloride.